By Gary M. White, MD
The skin is red and inflamed, like a very bad sunburn.
Radiodermatitis (RD) may be acute or chronic. In the acute setting, the skin is red and inflamed, analogous to a bad sunburn. Chronic radio dermatitis occurs months to years later and is characterized by thickening and fibrosis of the skin. Telangiectasias, loss of hair, and hypo or hyperpigmentation may be seen. Malignancy may develop in chronic radiation dermatitis.
It has recently been noted to occur in a localized area in the chest after coronary angioplasty or other procedures where fluoroscopy and/or cineradiography is used [BJD 1999;141;150]. In this scenario, a localized area of fibrosis, telangiectasia, and poikiloderma develops 1-2 years after the exposure.
With regard to acute RD, a topical steroid may be tried. The area should be monitored for the possibility of malignant change. For chronic RD, microneedle fractional radiofrequency treatment has been recommended [JAMA Derm 2017;153;478], as has pulsed-dye laser, fractional carbon dioxide laser and epidermal grafting [Semin Cut Med Surg;2015;34;42].
Telangiectasias may form after radiation therapy for breast cancer. Note patient also has a herpes outbreak.
Chronic changes years after radiation therapy of an infantile hemangioma. This treatment is no longer used.
Another case of telangiectasia formation in the port of treatment for breast cancer.
This man had an aggressive neoplasm of the scalp excised and then the bed radiated. Fibrosis, telangiectasia, and a non-healing ulcer resulted.
Long-term changes of thickening and telangiectasias.
The left breast is swollen, red, and inflamed.
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